Debra Brock met the nurse prescriber specialising in aesthetics, and Neostrata distributor, to find out how to choose active skincare that works, and steer clear of what causes more harm than good.

DB: How did you first get interested in skincare?

LB: I’m a nurse and specialised in dermatology during my time in the NHS. I was fascinated by how we could treat serious diseases of the skin, but wanted to see what could be done for more everyday skin concerns. I started a private aesthetic practice and built a chain of clinics, which I later sold. I was doing some training work for a brand in France and Italy when I came across US skincare brand, NeoStrata, which I now distribute in the UK.

DB: There’s obviously a vast array of skincare on the market – how should people choose what to buy?

LB: The first thing to say is that there are two categories of skincare products on the market, pharmaceutical and cosmetic. Pharmaceutical products can only be prescribed or dispensed by a medically qualified professional, whereas cosmetics are obviously sold much more widely. Sometimes you hear brands like NeoStrata referred to as ‘cosmeceuticals’, but that term doesn’t have any legal meaning. Our products are cosmetics, but they contain higher levels of active ingredients than those generally available on the high street. For that reason we only supply clinics, because it’s important that our products are introduced in a structured way, under supervision.

DB: What should customers be looking for when shopping?

LB: It’s really hard to buy skincare if you’re shopping on the high street, as there’s so little good advice available in store. I do recommend Googling products and trying to look at evidence and photographs, and questioning claims. For example, the phrase ‘clinically proven’ can mean so many things. When we use it we mean an ingredient or product has undergone a peer reviewed trial that’s been published in an academic journal. Similarly, if a brand has a dermatologist’s name on it – has that doctor been actively involved in the development of the products, or have they just put their name to products developed by someone else?

If you’re buying products with active ingredients, packaging is really important. We use things like metallised glass containers, for example, so that the products don’t oxidise and become useless. Quite often you see products in brown glass bottles on the shelves in store – sometimes that’s so that you can’t see the product inside oxidising once you’ve opened it.

DB: If actives are so important, what should we be looking for – and why are they helpful?

LB: NeoStrata’s founders are a dermatologist and a dermatopharmacologist who worked together on a ground-breaking study in the 1970s. They were looking for a treatment for a skin disease called ichthyosis, where the outer layer of the skin is overly thickened and scaly <Sali has this>. They found that a group of compounds had a great effect on reducing the thickness of the outer layer of the skin, whilst helping to support and thicken the epidermis and dermis beneath.

They called these compounds, which include things like glycolic acid and lactic acid, AHAs (alphahydroxyacids). Later they discovered that they could be used in anti-ageing skincare. AHAs are hugely useful for this purpose because when delivered properly they help dead skin cells on the surface shed gently while building and supporting the structure of lower levels in the skin. They resurface the skin and improve its texture. This revolutionised anti-ageing skincare and NeoStrata was born out of that research.

DB: A lot of people are worried about using AHAs in their skincare. Should they be?

LB: You do need to be a bit more careful when using ingredients that have a real effect on the skin. AHAs do increase sun sensitivity but you only need around an SPF2 to counteract that, and we should all be wearing a daily sunscreen with a much higher rating in any case. It’s a myth that they thin the skin, they actually thicken it but resurface the dead outer layer. Also AHAs don’t worsen acne but they can bring out what’s already beneath the surface at the start of treatment.

It’s important to realise that your skin’s surface is mildly acidic in any case, which is why it’s such a bad idea to use alkali soaps. You shouldn’t fear AHAs because they have the word acid in their name, but they do need careful introduction.

DB: What about if you’ve got particular skin conditions like sensitivity or rosacea, which I have?

LB: You will need to be careful about using AHAs. In our Restore line, designed for sensitive skins, we use PHAs (Polyhydroxy Acids) instead. These are gentler than AHAs because they are bigger molecules, which act as a ‘brake’ in how fast they work on the skin. They’re also powerfully humectant, which means they hold moisture in the skin. You also need to be careful about using things like cleansing brushes – I’d only recommend those for people with non-sensitive skin and even then lightly and gently and look for an oscillating head.

DB: What skincare concerns do people generally come to a clinic with?

LB: All sorts of things – they might want a general anti-ageing regime, they might want to reduce spots of pigmentation or they have sensitive, reactive skin. Clinics also see lots of cases of acne and oily skin. But most people come to clinic asking for an injectable or other procedure, and are surprised to find we have such knowledge about topical skincare. This always surprises me – the nurses and doctors in aesthetic clinics spend their lives dedicated to skin and facial aesthetics so really do understand what your skin needs.

DB: And what are the typical skincare mistakes that people are making before seeking professional help?

LB: They’ve sometimes bought multiple products containing lots of different active ingredients and the combination of those has caused a problem. There’s a trend now to have complex multi-step skincare routines. I don’t think you need to have that many products in your routine, providing the ones you do use are well formulated. And it’s not only important that your products have been tested, and their ingredients, but also that the whole regimen works. We test at all of these levels. If you’re using products from five or six different brands, that regimen will never have been tested.

A lot of people overuse thick moisturisers thinking that that will solve skincare issues. Moisturisers are essentially grease – what’s more likely to help a skin condition are the right actives and / or humectants that will hold water in the skin. And ALWAYS wear a broad spectrum SPF product.

Sometimes people are concerned about coming to a skincare clinic because they think they only offer pretty aggressive interventions. This isn’t the case. Our philosophy is that you’re better off having a few wrinkles but glowing skin, than dull skin with no wrinkles.

DB: If you could only have five ‘desert island’ products, what would you pick?

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